Deriving individualised /r/ targets from the acoustics of children's non-rhotic vowels.

In visual-acoustic biofeedback for rhotic errors, learners are guided to match the third formant (F3) location to a visual target on a real-time acoustic spectrum. As the acoustic properties of correct English /r/differ across speakers, this study aimed to improve target selection by investigating the validity of individualised targets derived from children's non-rhotic vowels. A previously proposed prediction formula was adjusted using data from a child normative sample and tested in two groups of children. Study 1 found that predicted values were unexpectedly higher than actual F3 values in children whose /r/ errors had been remediated. To understand this discrepancy, Study 2 applied the formula to typically developing children and found that predicted values were also higher than actual F3 values, suggesting that different normative data might better represent the current samples. An updated formula is proposed, which can be used to generate individualised targets within acoustic biofeedback applications.

Finding the experts in the crowd: Validity and reliability of crowdsourced measures of children's gradient speech contrasts.

Perceptual ratings aggregated across multiple nonexpert listeners can be used to measure covert contrast in child speech. Online crowdsourcing provides access to a large pool of raters, but for practical purposes, researchers may wish to use smaller samples. The ratings obtained from these smaller samples may not maintain the high levels of validity seen in larger samples. This study aims to measure the validity and reliability of crowdsourced continuous ratings of child speech, obtained through Visual Analog Scaling, and to identify ways to improve these measurements. We first assess overall validity and interrater reliability for measurements obtained from a large set of raters. Second, we investigate two rater-level measures of quality, individual validity and intrarater reliability, and examine the relationship between them. Third, we show that these estimates may be used to establish guidelines for the inclusion of raters, thus impacting the quality of results obtained when smaller samples are used.

Direction of attentional focus in biofeedback treatment for /r/ misarticulation.

BACKGROUND: Maintaining an external direction of focus during practice is reported to facilitate acquisition of non-speech motor skills, but it is not known whether these findings also apply to treatment for speech errors. This question has particular relevance for treatment incorporating visual biofeedback, where clinician cueing can direct the learner's attention either internally (i.e., to the movements of the articulators) or externally (i.e., to the visual biofeedback display). AIMS: This study addressed two objectives. First, it aimed to use single-subject experimental methods to collect additional evidence regarding the efficacy of visual-acoustic biofeedback treatment for children with /r/ misarticulation. Second, it compared the efficacy of this biofeedback intervention under two cueing conditions. In the external focus (EF) condition, participants' attention was directed exclusively to the external biofeedback display. In the internal focus (IF) condition, participants viewed a biofeedback display, but they also received articulatory cues encouraging an internal direction of attentional focus. METHODS & PROCEDURES: Nine school-aged children were pseudo-randomly assigned to receive either IF or EF cues during 8 weeks of visual-acoustic biofeedback intervention. Accuracy in /r/ production at the word level was probed in three to five pre-treatment baseline sessions and in three post-treatment maintenance sessions. Outcomes were assessed using visual inspection and calculation of effect sizes for individual treatment trajectories. In addition, a mixed logistic model was used to examine across-subjects effects including phase (pre/post-treatment), /r/ variant (treated/untreated), and focus cue condition (internal/external). OUTCOMES & RESULTS: Six out of nine participants showed sustained improvement on at least one treated /r/ variant; these six participants were evenly divided across EF and IF treatment groups. Regression results indicated that /r/ productions were significantly more likely to be rated accurate post- than pre-treatment. Internal versus external direction of focus cues was not a significant predictor of accuracy, nor did it interact significantly with other predictors. CONCLUSIONS: The results are consistent with previous literature reporting that visual-acoustic biofeedback can produce measurable treatment gains in children who have not responded to previous intervention. These findings are also in keeping with previous research suggesting that biofeedback may be sufficient to establish an external attentional focus, independent of verbal cues provided. The finding that explicit articulator placement cues were not necessary for progress in treatment has implications for intervention practices for speech-sound disorders in children.

Covert contrast in velar fronting: An acoustic and ultrasound study.

There is growing evidence that speech sound acquisition is a gradual process, with instrumental measures frequently revealing covert contrast in errors perceived to involve phonemic substitution. Ultrasound imaging has the potential to expand our understanding of covert contrast by showing whether a child uses different tongue shapes while producing sounds that are perceived as neutralised. This study used an ultrasound measure (Dorsum Excursion Index) and acoustic measures (VOT and spectral moments of the burst) to investigate overt and covert contrast between velar and alveolar stops in child speech. Participants were two children who produced a perceptually overt velar-alveolar contrast and two children who neutralised the contrast via velar fronting. Both acoustic and ultrasound measures revealed significant differences between perceptually distinct velar and alveolar targets. One child with velar fronting demonstrated covert contrast in one acoustic and one ultrasound measure; the other showed no evidence of contrast. Clinical implications are discussed in this article.

Positional velar fronting: an updated articulatory account.

This study develops the hypothesis that the child-specific phenomenon of positional velar fronting can be modeled as the product of phonologically encoded articulatory limitations unique to immature speakers. Children have difficulty executing discrete tongue movements, preferring to move the tongue and jaw as a single unit. This predisposes the child to produce undifferentiated linguopalatal contact, neutralizing the coronal-velar contrast. Adopting a phonetically sensitive model of phonology, I propose that children's difficulty with discrete tongue movement can be encoded in a violable constraint, Move.as-Unit. The positional nature of fronting reflects the fact that discrete lingual movement is penalized more heavily in the motorically challenging context of a larger gesture. This analysis is supported with a longitudinal study of one child (3 ; 9 to 4 ; 4) whose fronting was conditioned by both segmental and prosodic factors. Adopting Move.as-Unit in a Harmonic Grammar framework makes it possible to reframe disparate-seeming conditioning factors as a unified grammatical system.

The relationship between inexperienced listeners' perceptions and acoustic correlates of children's /r/ productions.

This study examined inexperienced listeners' perceptions of children's naturally produced /r/ sounds with reference to levels of accuracy determined by consensus between two expert clinicians. Participants rated /r/ sounds as fully correct, distorted or incorrect/non-rhotic. Second and third formant heights were measured to explore the relationship between acoustic cues and perceptual judgments. Inexperienced listeners' agreement was greater for correct productions than for distorted or incorrect/non-rhotic productions. In addition, inexperienced listeners' differentiation of intermediate versus fully incorrect /r/ had lower sensitivity and specificity relative to an acoustically defined threshold than experienced listeners' classification. These findings are consistent with results of previous studies highlighting the difficulty in identifying gradations of correctness in misarticulated /r/, and they suggest that this ability may be influenced by clinical experience. Additionally, all listeners were noted to be more consistent in rating vocalic /r/ than consonantal /r/. Implications for clinician training and treatment planning are discussed.

Selecting an acoustic correlate for automated measurement of American English rhotic production in children.

Purpose: A current need in the field of speech-language pathology is the development of reliable and efficient techniques to evaluate accuracy of speech targets over the course of treatment. As acoustic measurement techniques improve, it should become possible to use automated scoring in lieu of ratings from a trained clinician in some contexts. This study asks which acoustic measures correspond most closely with expert ratings of children's productions of American English /ɹ/ in an effort to develop an automated scoring algorithm for use in treatment targeting rhotics. Method: A series of ordinal mixed-effects regression models were fit over a large sample of children's productions of words containing /ɹ/ that had previously been rated by three trained clinicians. Akaike/Bayesian Information Criteria were used to select the best-fitting model. Result: Controlling for age, sex, and allophonic contextual differences, the measure that accounted for the most variance in speech rating was F3-F2 distance normalised relative to a sample of age- and sex-matched speakers. Conclusion: We recommend this acoustic measure for use in future automated scoring of children's production of American English rhotics. We also suggest that computer-based treatment with automated scoring should facilitate increases in treatment dosage by improving options for home practice.

Efficacy of Visual-Acoustic Biofeedback Intervention for Residual Rhotic Errors: A Single-Subject Randomization Study.

Purpose: This study documented the efficacy of visual-acoustic biofeedback intervention for residual rhotic errors, relative to a comparison condition involving traditional articulatory treatment. All participants received both treatments in a single-subject experimental design featuring alternating treatments with blocked randomization of sessions to treatment conditions. Method: Seven child and adolescent participants received 20 half-hour sessions of individual treatment over 10 weeks. Within each week, sessions were randomly assigned to feature traditional or biofeedback intervention. Perceptual accuracy of rhotic production was assessed in a blinded, randomized fashion. Each participant's response to the combined treatment package was evaluated by using effect sizes and visual inspection. Differences in the magnitude of response to traditional versus biofeedback intervention were measured with individual randomization tests. Results: Four of 7 participants demonstrated a clinically meaningful response to the combined treatment package. Three of 7 participants showed a statistically significant difference between treatment conditions. In all 3 cases, the magnitude of within-session gains associated with biofeedback exceeded the gains associated with traditional treatment. Conclusions: These results suggest that the inclusion of visual-acoustic biofeedback can enhance the efficacy of intervention for some individuals with residual rhotic errors. Further research is needed to understand which participants represent better or poorer candidates for biofeedback treatment.

Perception-production relations in later development of American English rhotics.

It is known that some adult listeners have more sharply defined perceptual categories than others, and listeners with more precise auditory targets are also more precise in their production of contrasts. There is additionally evidence that children who have not yet mastered production of a contrast show diminished performance on perceptual measures of the same contrast. To date, however, few studies have investigated developmental perception-production relations using the fine-grained measures typical of adult studies. Existing evidence suggests that perception and production can be closely connected in development, but this relationship may break down as perception and articulation mature at different rates. This study evaluated perception and production of the English /r-w/ contrast in 40 typically-developing children aged 9-14. Perceptual sensitivity was measured with a logistic function fitted over responses in a forced-choice identification task using two synthetic 10-step continua from rake to wake. Participants also produced rhotic and non-rhotic words. Across participants, there was a significant correlation between perceptual acuity and rhoticity in production, although this effect was only observed for one of two continua tested. These results provide preliminary evidence compatible with the hypothesis that children with a more refined auditory target for a sound also produce that sound more accurately.

Ultrasound Images of the Tongue: A Tutorial for Assessment and Remediation of Speech Sound Errors.

Diagnostic ultrasound imaging has been a common tool in medical practice for several decades. It provides a safe and effective method for imaging structures internal to the body. There has been a recent increase in the use of ultrasound technology to visualize the shape and movements of the tongue during speech, both in typical speakers and in clinical populations. Ultrasound imaging of speech has greatly expanded our understanding of how sounds articulated with the tongue (lingual sounds) are produced. Such information can be particularly valuable for speech-language pathologists. Among other advantages, ultrasound images can be used during speech therapy to provide (1) illustrative models of typical (i.e. "correct") tongue configurations for speech sounds, and (2) a source of insight into the articulatory nature of deviant productions. The images can also be used as an additional source of feedback for clinical populations learning to distinguish their better productions from their incorrect productions, en route to establishing more effective articulatory habits. Ultrasound feedback is increasingly used by scientists and clinicians as both the expertise of the users increases and as the expense of the equipment declines. In this tutorial, procedures are presented for collecting ultrasound images of the tongue in a clinical context. We illustrate these procedures in an extended example featuring one common error sound, American English /r/. Images of correct and distorted /r/ are used to demonstrate (1) how to interpret ultrasound images, (2) how to assess tongue shape during production of speech sounds, (3), how to categorize tongue shape errors, and (4), how to provide visual feedback to elicit a more appropriate and functional tongue shape. We present a sample protocol for using real-time ultrasound images of the tongue for visual feedback to remediate speech sound errors. Additionally, example data are shown to illustrate outcomes with the procedure.

Differential Effects of Visual-Acoustic Biofeedback Intervention for Residual Speech Errors.

Recent evidence suggests that the incorporation of visual biofeedback technologies may enhance response to treatment in individuals with residual speech errors. However, there is a need for controlled research systematically comparing biofeedback versus non-biofeedback intervention approaches. This study implemented a single-subject experimental design with a crossover component to investigate the relative efficacy of visual-acoustic biofeedback and traditional articulatory treatment for residual rhotic errors. Eleven child/adolescent participants received ten sessions of visual-acoustic biofeedback and 10 sessions of traditional treatment, with the order of biofeedback and traditional phases counterbalanced across participants. Probe measures eliciting untreated rhotic words were administered in at least three sessions prior to the start of treatment (baseline), between the two treatment phases (midpoint), and after treatment ended (maintenance), as well as before and after each treatment session. Perceptual accuracy of rhotic production was assessed by outside listeners in a blinded, randomized fashion. Results were analyzed using a combination of visual inspection of treatment trajectories, individual effect sizes, and logistic mixed-effects regression. Effect sizes and visual inspection revealed that participants could be divided into categories of strong responders (n = 4), mixed/moderate responders (n = 3), and non-responders (n = 4). Individual results did not reveal a reliable pattern of stronger performance in biofeedback versus traditional blocks, or vice versa. Moreover, biofeedback versus traditional treatment was not a significant predictor of accuracy in the logistic mixed-effects model examining all within-treatment word probes. However, the interaction between treatment condition and treatment order was significant: biofeedback was more effective than traditional treatment in the first phase of treatment, and traditional treatment was more effective than biofeedback in the second phase. This is consistent with existing theory and data suggesting that detailed knowledge of performance feedback is most effective in the early stages of motor learning. Further research is needed to confirm that an initial phase of biofeedback has a facilitative effect, and to determine the optimal duration of biofeedback treatment. In addition, there is a strong need for correlational studies to examine which individuals with residual speech errors are most likely to respond to treatment.

Deriving gradient measures of child speech from crowdsourced ratings.

Recent research has demonstrated that perceptual ratings aggregated across multiple non-expert listeners can reveal gradient degrees of contrast between sounds that listeners might transcribe identically. Aggregated ratings have been found to correlate strongly with acoustic gold standard measures both when individual raters use a continuous rating scale such as visual analog scaling (Munson et al., 2012) and when individual raters provide binary ratings (McAllister Byun, Halpin, & Szeredi, 2015). In light of evidence that inexperienced listeners use continuous scales less consistently than experienced listeners, this study investigated the relative merits of binary versus continuous rating scales when aggregating responses over large numbers of naive listeners recruited through online crowdsourcing. Stimuli were words produced by children in treatment for misarticulation of North American English /r/. Each listener rated the same 40 tokens two times: once using Visual Analog Scaling (VAS) and once using a binary rating scale. The gradient rhoticity of each item was then estimated using (a) VAS click location, averaged across raters; (b) the proportion of raters who assigned the "correct /r/" label to each item in the binary rating task (pˆ). First, we validate these two measures of rhoticity against each other and against an acoustic gold standard. Second, we explore the range of variability in individual response patterns that underlie these group-level data. Third, we integrate statistical, theoretical, and practical considerations to offer guidelines for determining which measure to use in a given situation.

Online crowdsourcing for efficient rating of speech: a validation study.

UNLABELLED: Blinded listener ratings are essential for valid assessment of interventions for speech disorders, but collecting these ratings can be time-intensive and costly. This study evaluated the validity of speech ratings obtained through online crowdsourcing, a potentially more efficient approach. 100 words from children with /r/ misarticulation were electronically presented for binary rating by 35 phonetically trained listeners and 205 naïve listeners recruited through the Amazon Mechanical Turk (AMT) crowdsourcing platform. Bootstrapping was used to compare different-sized samples of AMT listeners against a "gold standard" (mode across all trained listeners) and an "industry standard" (mode across bootstrapped samples of three trained listeners). There was strong overall agreement between trained and AMT listeners. The "industry standard" level of performance was matched by bootstrapped samples with n = 9 AMT listeners. These results support the hypothesis that valid ratings of speech data can be obtained in an efficient manner through AMT. Researchers in communication disorders could benefit from increased awareness of this method. LEARNING OUTCOMES: Readers will be able to (a) discuss advantages and disadvantages of data collection through the crowdsourcing platform Amazon Mechanical Turk (AMT), (b) describe the results of a validity study comparing samples of AMT listeners versus phonetically trained listeners in a speech-rating task.

A multidimensional investigation of children's /r/ productions: perceptual, ultrasound, and acoustic measures.

PURPOSE: This study explored relationships among perceptual, ultrasound, and acoustic measurements of children's correct and misarticulated /r/ sounds. Longitudinal data documenting changes across these parameters were collected from 2 children who acquired /r/ over a period of intervention and were compared with data from children with typical speech. METHOD: Participants were 3 children with typical speech, recorded once, and 2 children with /r/ misarticulation, recorded over 7-8 months. The following data from /r/ produced in nonwords were collected: perceptually rated accuracy, ultrasound measures of tongue shape, and F3 - F2 distance. RESULTS: Regression models revealed significant associations among perceptual, ultrasound, and acoustic measures of /r/ accuracy. The inclusion of quantitative tongue-shape measurements improved the match between the ultrasound and perceptual/acoustic data. Perceptually incorrect /r/ productions were found to feature posteriorly located peaked tongue shapes. Of the children who were seen longitudinally, 1 developed a bunched /r/ and 1 demonstrated retroflexion. The children with typical speech also differed in their tongue shapes. CONCLUSION: Results support the validity of using qualitative and quantitative ultrasound measures to characterize the accuracy of children's /r/ sounds. Clinically, findings suggest that it is important to encourage pharyngeal constriction while allowing children to find the /r/ tongue shape that best fits their individual vocal tract.